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Dig Liver Dis. 2002 Jun;34(6):419-23.

Long-term maintenance treatment in ulcerative colitis: a 10-year follow-up.

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  • 1Gastrointestinal Unit, Pisa Hospital, Italy. gbresci@libero.it

Abstract

BACKGROUND:

With the extensive use of mesalamine, the natural history of ulcerative colitis is probably changed.

AIM:

To evaluate the relapse rate and the duration of remission in patients with ulcerative colitis on maintenance treatment with mesalamine.

PATIENTS AND METHODS:

Enrolled in the study were 95 patients divided into 4 groups according to macroscopic location of the disease and treated with the same therapy starting from the date of enrolment. Patients in all 4 groups were followed-up until relapse occurred. The disease activity was evaluated by the Clinical Activity Index and Endoscopic Index. Patients suitable for recruitment showed a Clinical Activity Index and Endoscopic Index lower than 6 and 4, respectively. The patients with ulcerative pancolitis or left-sided colitis were treated with 1.6 g/day while the cases with proctosigmoiditis or proctitis were treated with 5-acetylsalicylic acid enemas 4 g/day Each patient was evaluated with clinical and endoscopic assessment at a 6-month interval. Relapse was defined as an increase in Clinical Activity Index and Endoscopic Index, of more than 6 and 4, respectively.

RESULTS:

Five patients dropped-out. All enrolled patients showed a clinical and/or endoscopic relapse within 10 years, the majority 2 or 3 years after diagnosis: pancolitis and left-sided colitis within 2-3 years and patients with distal colitis within 9-10 years.

CONCLUSIONS:

A relapse was observed in most cases within 3 years, and in all recruited patients within a space of ten years. The extent of the disease in the colon is an important prognostic factor, as patients with distal colitis showed a lesser tendency to relapse.

PMID:
12132789
[PubMed - indexed for MEDLINE]
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